The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #72603

Lawrence J. Ouellet, PhD and Susan L. Bailey, PhD. School of Public Health, Division of Epidemiology and Biostatistics, University of Illinois at Chicago (MC 923), 1603 W. Taylor Street, Chicago, IL 60612, 312-355-0145, ljo@uic.edu

Background/Objectives: Seemingly conflicting study results regarding the length of time between initiation of illicit drug injection and consequent HCV infection complicate the development of public health policies for preventing HCV infection. This analysis uses recent data from Chicago to assess opportunities for HCV infection prevention in new IDUs. Methods: Survey and serological data from 15-30 year old IDUs in Chicago were examined from two CDC-funded studies, CIDUS-II (1997-1999, n=700) and CIDUS-III/DUIT (July 2002-ongoing, n=380)). Similar methods were used to recruit community-based samples of IDUs, assess risk behaviors, and determine HCV serostatus. Findings were assessed in the context of current research literature on HCV infection in young and new IDUs. Results: Of the 1080 participants, median age was 23.5 years, median years of injecting was 2.5, and 51% resided in suburbs. Most (78%) were HCV seronegative, but 60% reported injecting with a person >=5 years older, 53% recently shared needles and 74% shared other injection paraphernalia. Age and duration of injection were strongly associated with infection. Conclusions: Considerable opportunity for primary prevention is indicated by the large numbers of young, high-risk IDUs that can be accessed early in their injection careers before becoming infected with HCV. Secondary prevention targeting older IDUs also is needed as evidenced by this population’s higher levels of infection and interaction with new IDUs, seen in these studies and elsewhere. Secondary interventions should emphasize the potential role of older IDUs in preventing infection among the new IDUs they use drugs with and initiate into injecting.

Learning Objectives:

• Better understand the history of assessing the rate of new HCV infections among IDUs.
• Develop a plan for implementing HCV prevention interventions that is appropriate for local conditions and capacities.

Keywords: Hepatitis C, Injecting Drug Use

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.